Killer Pain Killers-How to Avoid Overmedication After an Accident

One of the most terrifying things I have witnessed in over twenty years of practicing personal injury law in Miami–as well as representing people across the country in suing grocery stores, litigating car accidents and processing cruise ship passenger injury claims–is when a relatively simple and minor injury snowballs into a catastrophic life-altering experience that threatens to end the journey. Worse still, often the threat comes not from the accident itself but from the treatment received ostensibly to relieve the pain. LEER EN ESPAÑOL.

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Frequently after the victim of a bike accident or trip is seen by a health care provider in Florida, the patient is prescribed a narcotic pain medication. Narcotic painkillers are now the most widely prescribed class of drugs in this country; they are also involved in an estimated 16,000 overdose deaths annually, largely involving their abuse.

These drugs can be used to treat either a specific part of the body, as in lower-back pain or headaches, or for large regions of the body, as in fibromyalgia or osteoarthritis. Often this will be the first time most of our clients have been injured and received a prescription for a pain medication.

TAKING PAIN PILLS AFTER AN ACCIDENT

After an accident, if the pain persists or even increases over time, it develops into a medical condition known as chronic pain. Once a client develops chronic pain, the pain itself then becomes not just a symptom of the initial injury, but actually a disease itself, with its own physical, emotional and psychological consequences. Moreover, a client who develops chronic pain faces a significant risk of taking prescribed pain medication for a prolonged period of time, a prospect which itself poses tremendous emotional and physical risks of dependency.

Unfortunately, in the case of narcotic pain medication, the cure can often cause the patient more problems than the original malady. For example, car accident victims who become dependent on or addicted to narcotic pain medication–such as OxyContin–can experience difficulty functioning in society, since the medication can cause a significant depression and inability to work, controlling their drives and destroying the quality of their lives. Usually, the course of treatment will involve a period of physical therapy.

Patients, their families, and doctors can become frustrated when and if they are unable to see relief from pain after time. In many cases when physical therapy does not help, doctors will suggest more aggressive and invasive strategies, such as injections and then surgery. Unfortunately, in many cases even a series of injections and surgery cannot relieve the long-term chronic pain and suffering that some accident victims endure–now facing long-term suffering or even a lifetime of chronic pain and disability.

It does not take long for anyone who takes a narcotic medication to develop a dependency or addiction. And some people are at greater risk than others, depending upon their age, medical history, and other medications they may already be taking. I have seen clients develop an addiction to a prescription medication after a relatively minor accident. The risk of addiction is far more serious, and is an often underestimated consequence that can shatter a life, posing far more consequences than the initial accident.

Two categories of drugs are prescribed to patients for pain–first, short-acting medications, like Percocet and Vicodin, often combined with over-the-counter painkillers; and, second, long-acting time-release painkillers, including drugs like OxyContin, fentanyl and methadone.

In 2012, 35 of our country’s leading health care providers signed a petition demanding that the FDA initiate new rules to prevent the overuse and abuse of prescription painkillers to treat minor to moderate pain. Edward Covington, the director of Neurological Center for Pain at the Cleveland Clinic, issued the following statement: “Over prescribing of opioids is harming many chronic pain patients.” The petitioners asked the FDA to change the labeling on pain medication to educate doctors that the medications should be limited to the treatment of cancer patients–which would not prevent doctors from prescribing them in an off-label manner, anyway. To learn more about how some doctors prescribe medication and use medical devices in a manner that is not specifically approved by the FDA, please read my recent blog in the Huffington Post: “Medtronic Manipulates Safety Data — When a Fine Should Become a Crime.”

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In response to the petitioner, the FDA held a two-day public hearing on the epidemic of addiction and overdose deaths fueled by opioid pain medications like OxyContin, which is manufactured by Purdue Pharma.

The FDA first approved OxyContin in Dec. 1995; since then the medication has often been abused by users who crush, snort, and inject it–effectively causing it to be absorbed and released into the body more rapidly, thus resulting in overdosing or even death. In April 2010, the FDA approved a reformulated version of OxyContin, which was designed to be more difficult to manipulate for purposes of misuse or abuse.

In addition, OxyContin has often been used by patients at extremely high dosages and for extended periods of time. Yet, despite a clear history of such abuse, Purdue Pharma has never conducted any verified clinical studies evaluating the long-term risks of OxyContin. Recently, independent studies have, however, associated narcotic painkillers with a variety of dangers, such as sleep apnea, increased falls and hip fractures.

THE FDA DEMANDS CHANGES TO OXYCONTIN LABELING

Recently the FDA announced that Purdue Pharma updated its labeling of the reformulated OxyContin to make abuse difficult. Additionally, because the benefits of original OxyContin no longer outweigh its risks, the original OxyContin was withdrawn from sale for reasons of safety or effectiveness. The new version of the drug is more difficult to crush, break, or dissolve. It also forms a viscous hydrogel and cannot be easily prepared for injection.

Pharmacies and pharmacists who dispense narcotic pain meds share in the responsibility for the pain pill epidemic that is sweeping our country. And this week, our nation’s largest drugstore, Walgreens, was hit with an $80 million fine following a DEA investigation that revealed its failure to properly control the sale of controlled drugs by failing to account for sales and report suspicious activity.

The fine is the largest ever assessed against a national pharmacy chain, and it resulted in the suspension of a license for at least one of the Walgreens Florida locations for two years. Florida seems to be the epicenter of prescription drug abuse and is often referred to as the “pill mill” capital of the country. Since 2009 there have been 59 Federal investigations of doctors for illegally prescribing drugs.

It is important to understand the risks of becoming dependent on painkillers after an accident and to monitor the signs and symptoms of addiction. If you feel that you are at risk of addiction, consult with a qualified medical doctor who can properly assess your condition and assist in a careful and supervised withdrawal.